Download PDF
Osteosynthesis and Trauma Care 2005; 13(4): 214-218
DOI: 10.1055/s-2005-836622
Original Article

© Georg Thieme Verlag Stuttgart · New York

Hemiarthroplasty for Displaced Intracapsular Femoral Neck Fractures

J. Bartoníček1 , J. Skála-Rosenbaum1 , V. Džupa1 , P. Douša1
  • 1Orthopaedic Department, 3rd Faculty of Medicine, Charles University, Prague-Vinohrady, Prague, Czech Republic
Further Information

Publication History

Publication Date:
01 December 2005 (online)

    Permissions and Reprints

Abstract

Hemiarthroplasty still plays an irreplaceable role in the therapeutic algorithm of the treatment of displaced intracapsular femoral neck fractures. In elderly patients (over 80 years old), in a poorer general condition (ASA III and more), with low life activity, we prefer a cemented monoblock. In cases of biologically younger patients where the general or local condition does not allow performance of a total arthroplasty, a modular hemiarthroplasty with a replaceable head is indicated as it facilitates an easy conversion to total prosthesis in cases of erosion of the acetabulum. Of vital importance in all cases is the correct surgical technique, observing the relation between the head centre and the apex of the greater trochanter, i. e., the head centre has to be 1 to 2 mm below the apex of the greater trochanter. Of no less importance is the correct anteversion and suture of the capsule as a means of prevention of postoperative dislocation.

Key words

intracapsular femoral neck fractures - hemiarthroplasty - proximal femur fractures

References

  • 1 Bartoníček J, Bartoš M. Operační přístupy při aloplastice kyčelního kloubu (Anatomické poznámky). [Surgical approaches in total hip arthroplasty - anatomical notes].  Acta Chir Orthop Traum Čech. 1986;  53 405-415
    PubMedSearch in Google Scholar
  • 2 Bhandari M, Devereaux P J, Swiontkowski M F, Tornetta P, Obremskey W, Koval J K, Nork S, Sprague S, Schemitsch E H, Guyatt G H. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis.  J Bone Joint Surg [Am]. 2003;  85 1673-1681
    PubMedSearch in Google Scholar
  • 3 Cornell C N, Levine D, O'Dohert J, Lyden J. Unipolar versus bipolar hemiarthroplasty for the treatment of femoral neck fractures in the elderly.  Clin Orthop. 1998;  348 67-71
    PubMedSearch in Google Scholar
  • 4 Degreif J, Müller L P, Runkel M, Blum J, Willmann G. Long-term results after operative treatment of femoral neck fractures with ceramic head prosthesis.  Orthopaedics. 2001;  24 129-133
    PubMedSearch in Google Scholar
  • 5 Devas M, Hinves B. Prevention of acetabular erosion after hemiarthroplasty for fractured neck of femur.  J Bone Joint Surg [Br]. 1983;  65 548-551
    PubMedSearch in Google Scholar
  • 6 Džupa V, Bartoníček J, Skála-Rosenbaum J. Rozbor pacientů léčených v roce 1997 pro zlomeninu proximálního femuru - základní analýza souboru. [Analysis of patients treated in 1997 for proximal femur fractures - basic analysis of the group].  Acta Chir Orthop Traum Čech. 1999;  66 235-239
    PubMedSearch in Google Scholar
  • 7 Džupa V, Bartoníček J, Skála-Rosenbaum J, Príkazský V. Úmrtí pacientů se zlomeninou proximálního femuru v průběhu prvního roku po úrazu. [Mortality of patients with proximal femur fractures during the first year after the injury].  Acta Chir Orthop Traum Čech. 2002;  69 39-44
    PubMedSearch in Google Scholar
  • 8 Beghard J S, Amstutz H C, Zinar D M, Dorey F J. A Comparison of total hip arthroplasty for treatment of acute fracture of the femoral neck.  Clin Orthop. 1992;  282 123-131
    PubMedSearch in Google Scholar
  • 9 Gilbert M S, Capozzi J. Unipolar or bipolar prosthesis for the displaced intracapsular hip fractures.  Clin Orthop. 1998;  353 81-85
    PubMedSearch in Google Scholar
  • 10 Huggler A H. Die Alloarthroplastik des Hüftgelenkes mit Femurschaft- und Totalendoprothesen. Thieme, Stuttgart 1968; 102
  • 11 Khan R JK, MacDowell A, Crossman P, Datta A, Jallali N, Arch B N, Keene G S. Cemented or uncemented hemiarthroplasty for displaced intracapsular femoral neck fractures.  Int Orthop (SICOT). 2002;  26 229-232
    CrossrefPubMedSearch in Google Scholar
  • 12 Kofoed H, Kofoed J. Moore prosthesis in the treatment of fresh femoral neck fractures.  Injury. 1983;  14 531-540
    CrossrefPubMedSearch in Google Scholar
  • 13 Kusaba A, Kuroki Y. Wear of bipolar prosthesis.  J Arthroplasty. 1998;  13 668-673
    PubMedSearch in Google Scholar
  • 14 Ledinger W, Hoffmann G, Meierhofer J N, Wölfel R. Verminderung von schweren kardialen Komplikationen während der Implantation von zementierten Hüfttotalendoprothesen bei Oberschenkelhalsfrakturen.  Unfallchirurg. 2002;  105 675-679
    CrossrefPubMedSearch in Google Scholar
  • 15 Lu-Yao G L, Keller R B, Littenberg B, Wennberg J E. Outcomes after displaced fractures of the femoral neck. A meta-analysis of one hundred and six published reports.  J Bone Joint Surg [Am]. 1994;  76 15-25
    PubMedSearch in Google Scholar
  • 16 Martínez A A, Herrera A, Cuenca J, Panisello J J, Tabuenca A. Comparison of two different posterior approachs for hemiarthroplasty of the hip.  Arch Orthop Trauma Surg. 2002;  122 51-52
    PubMedSearch in Google Scholar
  • 17 Müller M E, Allgöwer M, Willenegger H. Technique of internal fixation of fractures. Springer, Berlin 1965; 272
  • 18 Müller L P, Degreif J, Basten K, Zöphel O, Rommens P M. Is there still an indication for operative treatment of femoral neck fractures with a ceramic hemiprosthesis?.  Arch Orthop Trauma Surg. 2000;  120 299-303
    PubMedSearch in Google Scholar
  • 19 Müller L P, Degreif J, Hely H, Mehler D, Otto M, Rommens P M. Friction in hip hemiendoprosthesis. Review of literature and own model using cadaveric acetabula.  Hip Inter. 2002;  12 126-134
    PubMedSearch in Google Scholar
  • 20 Ong B C, Maurer S G, Aharonoff G B, Zuckerman J D, Koval K J. Unipolar versus bipolar hemiarthroplasty: functional outcome after femoral neck fracture at a minimum of thirty-six months of follow-up.  J Orthop Trauma. 2002;  16 317-322
    CrossrefPubMedSearch in Google Scholar
  • 21 Pajarinen J, Savolainen V, Tulikoura I, Lindahl J, Hirvensalo E. Factors predisposing to dislocation of the Thompson hemiarthroplasty.  Acta Orthop Scand. 2003;  74 45-48
    CrossrefPubMedSearch in Google Scholar
  • 22 Parker M J. The management of intracapsular fractures of the proximal femur.  J Bone Joint Surg [Br]. 2000;  82 937-941
    PubMedSearch in Google Scholar
  • 23 Paton R W, Hirst P. Hemiarthroplasty of the hip and dislocation.  Injury. 1989;  20 167-169
    CrossrefPubMedSearch in Google Scholar
  • 24 Phillips T W. Thompson hemiarthroplasty and acetabular erosion.  J Bone Joint Surg [Am]. 1989;  71 913-917
    PubMedSearch in Google Scholar
  • 25 Rogmark C, Carlsson A, Johnell O, Sernbo I. Costs of internal fixation and arthroplasty for displaced femoral neck fracture.  Acta Orthop Scand. 2003;  74 293-298
    CrossrefPubMedSearch in Google Scholar
  • 26 Soreide O, Lillestol J, Alho A, Hvidsten K. Acetabular protrusion following endoprosthetic hip surgery: a multifactorial study.  Acta Orthop Scand. 1980;  51 943-948
    PubMedSearch in Google Scholar
  • 27 Sosna A, Čech O. Zadní operační přístup při aplikaci cervikokapitální endoprotézy. [Posterior surgical approach in the application of hemiarthroplasty].  Acta Chir Orthop Traum Čech. 1973;  40 537-543
    PubMedSearch in Google Scholar

Prof. Jan BartoníčekMD, DSc 

Orthopaedic Department · 3rd Faculty of Medicine · Charles University · Prague-Vinohrady

Šrobárova 50

10034 Prague 10

Czech Republic

Phone: +4 20/2/67 16 27 16

Fax: +4 20/2/67 31 33 72

Email: bartonic@fnkv.cz